Cardiometabolic Benefits of Intermittent Fasting

2021 ◽  
Vol 41 (1) ◽  
pp. 333-361
Author(s):  
Krista A. Varady ◽  
Sofia Cienfuegos ◽  
Mark Ezpeleta ◽  
Kelsey Gabel

This review aims to summarize the effects of intermittent fasting on markers of cardiometabolic health in humans. All forms of fasting reviewed here—alternate-day fasting (ADF), the 5:2 diet, and time-restricted eating (TRE)—produced mild to moderate weight loss (1–8% from baseline) and consistent reductions in energy intake (10–30% from baseline). These regimens may benefit cardiometabolic health by decreasing blood pressure, insulin resistance, and oxidative stress. Low-density lipoprotein cholesterol and triglyceride levels are also lowered, but findings are variable. Other health benefits, such as improved appetite regulation and favorable changes in the diversity of the gut microbiome, have also been demonstrated, but evidence for these effects is limited. Intermittent fasting is generally safe and does not result in energy level disturbances or increased disordered eating behaviors. In summary, intermittent fasting is a safe diet therapy that can produce clinically significant weight loss (>5%) and improve several markers of metabolic health in individuals with obesity.

Author(s):  
Gregory J. H. Biddle ◽  
Joseph Henson ◽  
Stuart J. H. Biddle ◽  
Melanie J. Davies ◽  
Kamlesh Khunti ◽  
...  

Isotemporal substitution modelling (ISM) and compositional isotemporal modelling (CISM) are statistical approaches used in epidemiology to model the associations of replacing time in one physical behaviour with time in another. This study’s aim was to use both ISM and CISM to examine and compare associations of reallocating 60 min of sitting into standing or stepping with markers of cardiometabolic health. Cross-sectional data collected during three randomised control trials (RCTs) were utilised. All participants (n = 1554) were identified as being at high risk of developing type 2 diabetes. Reallocating 60 min from sitting to standing and to stepping was associated with a lower BMI, waist circumference, and triglycerides and higher high-density lipoprotein cholesterol using both ISM and CISM (p < 0.05). The direction and magnitude of significant associations were consistent across methods. No associations were observed for hemoglobin A1c, total cholesterol, or low-density lipoprotein cholesterol for either method. Results of both ISM and CISM were broadly similar, allowing for the interpretation of previous research, and should enable future research in order to make informed methodological, data-driven decisions.


2018 ◽  
Vol 2 (21) ◽  
pp. 2848-2861 ◽  
Author(s):  
Moua Yang ◽  
Andaleb Kholmukhamedov ◽  
Marie L. Schulte ◽  
Brian C. Cooley ◽  
Na’il O. Scoggins ◽  
...  

Abstract Dyslipidemia is a risk factor for clinically significant thrombotic events. In this condition, scavenger receptor CD36 potentiates platelet reactivity through recognition of circulating oxidized lipids. CD36 promotes thrombosis by activating redox-sensitive signaling molecules, such as the MAPK extracellular signal-regulated kinase 5 (ERK5). However, the events downstream of platelet ERK5 are not clear. In this study, we report that oxidized low-density lipoprotein (oxLDL) promotes exposure of procoagulant phosphatidylserine (PSer) on platelet surfaces. Studies using pharmacologic inhibitors indicate that oxLDL-CD36 interaction–induced PSer exposure requires apoptotic caspases in addition to the downstream CD36-signaling molecules Src kinases, hydrogen peroxide, and ERK5. Caspases promote PSer exposure and, subsequently, recruitment of the prothrombinase complex, resulting in the generation of fibrin from the activation of thrombin. Caspase activity was observed when platelets were stimulated with oxLDL. This was prevented by inhibiting CD36 and ERK5. Furthermore, oxLDL potentiates convulxin/glycoprotein VI–mediated fibrin formation by platelets, which was prevented when CD36, ERK5, and caspases were inhibited. Using 2 in vivo arterial thrombosis models in apoE-null hyperlipidemic mice demonstrated enhanced arterial fibrin accumulation upon vessel injury. Importantly, absence of ERK5 in platelets or mice lacking CD36 displayed decreased fibrin accumulation in high-fat diet–fed conditions comparable to that seen in chow diet–fed animals. These findings suggest that platelet signaling through CD36 and ERK5 induces a procoagulant phenotype in the hyperlipidemic environment by enhancing caspase-mediated PSer exposure.


2017 ◽  
Vol 5 (10) ◽  
pp. e150 ◽  
Author(s):  
Elizabeth Victoria Eikey ◽  
Madhu C Reddy ◽  
Kayla M Booth ◽  
Lynette Kvasny ◽  
Johnna L Blair ◽  
...  

Author(s):  
Miguel Ramirez-Jimenez ◽  
Felix Morales-Palomo ◽  
Juan Fernando Ortega ◽  
Alfonso Moreno-Cabañas ◽  
Valle Guio de Prada ◽  
...  

Individuals with abdominal obesity and metabolic syndrome (MetS) have augmented risk of all-cause mortality. Lifestyle interventions are effective to treat MetS, however, there are periods during the year in which exercise programs are discontinued and improper dietary habits reappear (e.g., Christmas holidays). We aimed to analyze if exercise-training during Christmas holidays would avoid body-weight gains and cardiometabolic deterioration in MetS individuals, using a randomized control trial. Thirty-eight men with MetS undergoing exercise training were randomly allocated to either continue (TRAIN group, n = 16) or discontinue (HOLID group, n = 22) training, during the three weeks of Christmas. Anthropometrics (body weight, fat, and waist circumference), fasting blood metabolites (glucose, insulin, triglycerides, and cholesterol concentrations) and exercise maximal fat oxidation (FOMAX) and oxygen uptake (VO2PEAK) were determined before and after Christmas. Both groups were similar at baseline in all parameters (p > 0.05). HOLID group increased body weight (91.3 ± 13.0 to 92.0 ± 13.4 kg, p = 0.004), mean arterial pressure (94.0 ± 10.6 to 97.1 ± 8.9 mmHg, p = 0.026), blood insulin (10.2 ± 3.8 to 12.5 ± 5.4 µIU·mL−1, p = 0.003) and HOMA (3.2 ± 1.3 to 4.1 ± 2.3, p = 0.003). In contrast, TRAIN prevented those disarrangements and reduced total (170.6 ± 30.6 to 161.3 ± 31.3 mg·dL−1, p = 0.026) and low-density lipoprotein cholesterol (i.e., LDL-C, 104.8 ± 26.1 to 95.6 ± 21.7 mg·dL−1, p = 0.013). TRAIN also prevented the reductions in exercise FOMAX and VO2PEAK that was observed in the HOLID group (p = 0.002). In conclusion, exercise training during Christmas, prevents body weight gains and the associated cardiovascular (increase in blood pressure and LDL-C) and metabolic (reduced insulin sensitivity) health risks are an optimal non-pharmacological therapy for that period of the year.


Author(s):  
Stanisław Głuszek ◽  
Arkadiusz Bociek ◽  
Edyta Suliga ◽  
Jarosław Matykiewicz ◽  
Magdalena Kołomańska ◽  
...  

Methods of treating obesity, such as changes in lifestyle, physical activity, restrictive diets, and psychotherapy, are not sufficient. Currently, it is considered that in the case of patients who meet the eligibility criteria for surgery, the treatment of choice should be bariatric surgery. The aim of this study was to assess the weight loss and metabolic changes in a group of adults with obesity undergoing bariatric surgery. The study involved 163 patients whose body mass index (BMI) exceeded 40 or 35 kg/m2, concurrent with at least one metabolic sequelae. In 120 of the cases (74%), sleeve gastrectomy was used; in 35 (21%), gastric banding was used; and in 8 (5%), laparoscopic Roux-en-Y gastric bypass was used. Metabolic parameters such as total cholesterol, LDL-cholesterol (low-density lipoprotein cholesterol), HDL-cholesterol (high-density lipoprotein cholesterol), triglycerides, and glucose were measured preoperatively and postoperatively, as well as the creatinine, creatine kinase (CK-MB), and leptin activity. In patients undergoing bariatric surgery, a significant decrease in excess weight (p < 0.001) was observed at all the analyzed time points, compared to the pre-surgery value. Weight loss after surgery was associated with a significant improvement in glycemia (109.6 ± 48.0 vs. 86.6 ± 7.9 mg/dL >24 months after surgery; p = 0.003), triglycerides (156.9 ± 79.6 vs. 112.7 ± 44.3 mg/dL >24 months after surgery; p = 0.043) and leptin (197.50 ± 257.3 vs. 75.98 ± 117.7 pg/mL 12 months after surgery; p = 0.0116) concentration. The results of the research confirm the thesis on the effectiveness of bariatric surgery in reducing excess body weight and improving metabolic parameters in patients with extreme obesity.


2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 58-58
Author(s):  
Ellen O'Malley ◽  
Joshua Phelps ◽  
Christi Arthur ◽  
Reza Hakkak

Abstract Objectives The primary objectives of this study were to: assess change in dietary habits and health outcomes [body mass index (BMI), weight loss, waist circumference (WC), blood pressure, low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), and Hemoglobin A1c (A1C)] among patients following completion of an intensive cardiac rehabilitation (CR) program. Methods This retrospective cohort study involved de-identified data obtained from an electronic medical record (EMR) program and from an excel spreadsheet maintained at a hospital in Arkansas. Data were available from 138 adults, age 29 to 89 years, with a pre-existing heart condition or event, and who completed a 12-week CR program at the hospital's Clinic. Dietary habits were evaluated using the 24-question Rate Your Plate (RYP) survey at initial visit, and discharge. RYP and weight data were also available for a group of patients (n = 18) completing a 3-month follow-up visit. Results There was a statistically significant (P &lt; .0001) mean increase (8.24; 95% CI, 7.03 to 9.45) from the pre-RYP score (51.05 ± 7.43) to the post-RYP score (59.29 ± 6.58). There was a statistically significant (P &lt; .0005) median decrease in weight (−2.00 lbs.) after post-intervention (193.50 lbs.) compared to pre-intervention (195.50 lbs.). There were also significant (P &lt; .05) differences between pre- and post-measurements of BMI, WC, LDL, total cholesterol, and triglycerides. Follow-up data indicated significant changes in the RYP score (P &lt; .0001) and weight (P = .020) were maintained at 3-months follow-up. Conclusions A 12-week CR program including nutrition education and counseling is effective to help patients with CVD or previous heart events improve their dietary habits. There were noticeable changes in diet scores, WC, BMI, and weight loss, with patients being able to sustain weight loss at their three-month follow-up visit (a 5% weight loss). Funding Sources N/A.


2020 ◽  
Vol 45 (3) ◽  
pp. 340-343 ◽  
Author(s):  
Rand T. Akasheh ◽  
Cynthia M. Kroeger ◽  
John F. Trepanowski ◽  
Kelsey Gabel ◽  
Kristin K. Hoddy ◽  
...  

This study compared the weight loss efficacy of alternate-day fasting (ADF) versus daily calorie restriction (CR) in adults with subclinical hypothyroidism. After 6 months, body weight decreased (P < 0.001) similarly by ADF (–7% ± 1%) and CR (–8% ± 2%). Insulin resistance decreased (P < 0.05) more by ADF versus CR. Free thyroxin and thyroid-stimulating hormone remained unchanged. Thus, ADF and CR produce similar weight loss in this population, without affecting thyroid hormone levels. Novelty Intermittent fasting and daily restriction produce similar reductions in body weight in subjects with subclinical hypothyroidism.


2015 ◽  
Vol 14 (1) ◽  
Author(s):  
Kristin K Hoddy ◽  
Cynthia M Kroeger ◽  
John F Trepanowski ◽  
Adrienne R Barnosky ◽  
Surabhi Bhutani ◽  
...  

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